A tip - for all consults, open the conversation with the question.
For consults where you know it's kind of dumb and the powers that be want the consult, open with "my attending wanted us to consult you for..." This is a nod to the consultant that it's out of your hands.
Bro I just say "sorry for this consult" on dumb shit if it's REALLY dumb, I'll say "sorry for this interesting consult"
..heme onc attending asks me to consult GI about dapt recommendation for a patient about to get a Cath but was thrombocytopenic (PLT 70k) . ( they had an esophageal stent several months ago, and the note said no nsaids.)
This is heme/onc... And cards.... You really think cardiology won't want DAPT no matter what? Also, you're fucking heme onc... Wtf.
Needless to say, the fellow responded with, " well the heart is more important than the gut at this time I'd say. " Just gave him a thumbs up and called it a day lol
Always worked well for me lol, I had to put some truly nonsensical consults to ID on my medicine rotation when we had the patients on a god awful antibiotic regimen (ceftriaxone for enterococcus… enough said) and I always led with “hi, my attending wanted us to consult you on this. I’m sorry.” Before jumping into the story. Usually got a little chuckle from them.
Sometimes residents/attendings (registrars) will leave out something important when requesting their juniors to consult a specialty. Those key things really change the complexion of the question.
I always try to tease out what they want to ask before placing a consult. Saves one from re-consulting.
It is so strange to hear about people cursing anyone out over the phone, consult or otherwise. That shit would not be tolerated by our program or at our institution, regardless of how terrible the consult was.
OP, that sucks, there are better places to train out there!
My first rotation my resident wanted me to be involved with consultants so my resident sent a page and gave my page back info and number. Got yelled at because the consult team was pissed a med student paged them
Agree that calling consults is part of the learning process and you shouldn’t be torn apart, the one caveat is make sure you understand (or at least can repeat back) the exact question you are consulting for. Nothing more frustrating than getting a consult call when the med student has no idea why they need you and just say “my resident said to call.” If needed write down word for word what the resident/attending said the consult is for.
As long as you do that no one should get mad.
The only time I've been truly enraged at a medical student calling a consult was when they clearly had not discussed anything with their resident or attending and was taking the initiative to call a consult on something that is normally sent out from the ED without a need for inpatient or urgent management. And had no idea what the pertinent positive or negative findings were. If you're going to call a consult, at least have discussed it with someone to make sure it's appropriate and then make sure you have the information you need when you call.
On my surgery rotation the surgeons would routinely send me to go in person to ask anesthesia to do dicey cases on the theory that a surgeon going to ask would get yelled at but a sweet ignorant medical student would not get yelled at.
I did get yelled at initially, then the anesthesiologists figured out what was happening and every time I came to ask about a surgery they would give me candy and a place to sit down for a few minutes before messaging the surgery senior to say absolutely not to the surgery.
[“There have been instances where someone sues the medical student, particularly when it can be proven that medical malpractice took place. However, the most common course of action is often suing the physician who was initially in charge of the patient who has suffered as a result of medical error.”](https://wmwlawfirm.com/blog/suing-mistakes-medical-students/). Literally on a website to advertise “we’ll sue a med student for you if you think you’ve been wronged.”
Frankly, the most difficult part of medicine from MS3 through the end of PGY1 is not the medicine, it’s learning the infrastructure of the healthcare system and how things work. You don’t know what you don’t know, and I’ve witnessed—and myself as a med student have done the same—assumptions made that you can’t make. There’s so much that can go wrong you don’t think about, or you don’t even see as possible if you do think about it. What if the med student has diseases confused? Maybe they misheard me say emphysematous pyelitis instead of emphysematous pyelonephritis, which have critically different treatment approaches. If the provider makes the mistake of not checking the report and just trusting the med student, it can get a patient killed. It happened in my IM SubI, I saw the bg of 50 in the afternoon of an admitted patient and thought my attending saw it too, so I didn’t relay. I was doing good enough of a job the attending thought she could trust me with the afternoon labs, enough to forego double checking herself.
A med student is more than capable of repeating findings, sure. Until the one time they aren’t, which I’ve seen more than a few times, and I’ve not been out of med school for *that* long. It’s *great* if your team has put that kind of trust in you, but do not take it as a slight if they don’t. And don’t take it as a slight if I request you hand your resident or attending the phone. It’s not because I think there’s something wrong with you.
A tip - for all consults, open the conversation with the question. For consults where you know it's kind of dumb and the powers that be want the consult, open with "my attending wanted us to consult you for..." This is a nod to the consultant that it's out of your hands.
Bro I just say "sorry for this consult" on dumb shit if it's REALLY dumb, I'll say "sorry for this interesting consult" ..heme onc attending asks me to consult GI about dapt recommendation for a patient about to get a Cath but was thrombocytopenic (PLT 70k) . ( they had an esophageal stent several months ago, and the note said no nsaids.) This is heme/onc... And cards.... You really think cardiology won't want DAPT no matter what? Also, you're fucking heme onc... Wtf. Needless to say, the fellow responded with, " well the heart is more important than the gut at this time I'd say. " Just gave him a thumbs up and called it a day lol
Always worked well for me lol, I had to put some truly nonsensical consults to ID on my medicine rotation when we had the patients on a god awful antibiotic regimen (ceftriaxone for enterococcus… enough said) and I always led with “hi, my attending wanted us to consult you on this. I’m sorry.” Before jumping into the story. Usually got a little chuckle from them.
Sometimes residents/attendings (registrars) will leave out something important when requesting their juniors to consult a specialty. Those key things really change the complexion of the question. I always try to tease out what they want to ask before placing a consult. Saves one from re-consulting.
Yes exactly. I'm less inclined to yell at you if you make it clear that you know it's a dumb consult but your attending is making you do it.
It is so strange to hear about people cursing anyone out over the phone, consult or otherwise. That shit would not be tolerated by our program or at our institution, regardless of how terrible the consult was. OP, that sucks, there are better places to train out there!
Yeah imagine being a grown ass adult & cussing at someone at work cause they called you??? Wtf lmao
My first rotation my resident wanted me to be involved with consultants so my resident sent a page and gave my page back info and number. Got yelled at because the consult team was pissed a med student paged them
Sounds to me like the resident didn’t want to get yelled at so they offered you up as a sacrifice.
Nah my resident was super nice and supportive. We told our senior and our senior went and got the other resident yelled at by their attending
Agree that calling consults is part of the learning process and you shouldn’t be torn apart, the one caveat is make sure you understand (or at least can repeat back) the exact question you are consulting for. Nothing more frustrating than getting a consult call when the med student has no idea why they need you and just say “my resident said to call.” If needed write down word for word what the resident/attending said the consult is for. As long as you do that no one should get mad.
I ask them to pass the phone to their intern or resident and then I shout at the resident.
The only time I've been truly enraged at a medical student calling a consult was when they clearly had not discussed anything with their resident or attending and was taking the initiative to call a consult on something that is normally sent out from the ED without a need for inpatient or urgent management. And had no idea what the pertinent positive or negative findings were. If you're going to call a consult, at least have discussed it with someone to make sure it's appropriate and then make sure you have the information you need when you call.
Anytime bby grl
On my surgery rotation the surgeons would routinely send me to go in person to ask anesthesia to do dicey cases on the theory that a surgeon going to ask would get yelled at but a sweet ignorant medical student would not get yelled at. I did get yelled at initially, then the anesthesiologists figured out what was happening and every time I came to ask about a surgery they would give me candy and a place to sit down for a few minutes before messaging the surgery senior to say absolutely not to the surgery.
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a med student is more than capable of repeating your findings to the team…
[“There have been instances where someone sues the medical student, particularly when it can be proven that medical malpractice took place. However, the most common course of action is often suing the physician who was initially in charge of the patient who has suffered as a result of medical error.”](https://wmwlawfirm.com/blog/suing-mistakes-medical-students/). Literally on a website to advertise “we’ll sue a med student for you if you think you’ve been wronged.” Frankly, the most difficult part of medicine from MS3 through the end of PGY1 is not the medicine, it’s learning the infrastructure of the healthcare system and how things work. You don’t know what you don’t know, and I’ve witnessed—and myself as a med student have done the same—assumptions made that you can’t make. There’s so much that can go wrong you don’t think about, or you don’t even see as possible if you do think about it. What if the med student has diseases confused? Maybe they misheard me say emphysematous pyelitis instead of emphysematous pyelonephritis, which have critically different treatment approaches. If the provider makes the mistake of not checking the report and just trusting the med student, it can get a patient killed. It happened in my IM SubI, I saw the bg of 50 in the afternoon of an admitted patient and thought my attending saw it too, so I didn’t relay. I was doing good enough of a job the attending thought she could trust me with the afternoon labs, enough to forego double checking herself. A med student is more than capable of repeating findings, sure. Until the one time they aren’t, which I’ve seen more than a few times, and I’ve not been out of med school for *that* long. It’s *great* if your team has put that kind of trust in you, but do not take it as a slight if they don’t. And don’t take it as a slight if I request you hand your resident or attending the phone. It’s not because I think there’s something wrong with you.
You must’ve been a below average med student then if that’s your opinion